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General NPI Number Information
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NPI Number | 1790519619
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Entity Type | Individual
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Provider Name | AMBER LYNN OTKIN CNM, WHNP
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Gender | Female
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Dates
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Enumeration Date | 09/02/2024
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Last Update Date | 09/02/2024
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Provider Practice Location Address
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Address Line | 1417 S CLIFF AVE
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City | SIOUX FALLS
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State | SD
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Zip | 57105-1022
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Country | US
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Telephone | 605-322-8945
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 COUNTRY CLUB DR
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City | ELK POINT
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State | SD
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Zip | 57025-2179
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Country | US
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Telephone | 507-215-0209
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | CP003339
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | CM000112
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License Number State | SD
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